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Medication Administration: Enteral, Parenteral, and Percutaneous Routes

This chapter covers the procedures and techniques for administering medications through the enteral, parenteral, and percutaneous routes. It includes guidelines for oral, nasogastric, rectal, intradermal, subcutaneous, intramuscular, intravenous, and percutaneous medication administration. Safety precautions and considerations for each route are discussed.

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Medication Administration: Enteral, Parenteral, and Percutaneous Routes

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  1. Chapter 10 Preparing and Administering Medications

  2. Chapter 10 Lesson 10.1

  3. Learning Objectives • Compare dosage forms for drugs given by the enteral route • Outline procedures for giving medications enterally, parenterally, and percutaneously • List processes to prevent transmission of human immunodeficiency virus (HIV) and other blood-borne pathogens

  4. Enteral Medications • Medications given directly into the GI tract • Oral; Box 10-1 Oral Medication Forms • Nasogastric or PEG • Rectal

  5. Oral Administration • Asepsis • Steps to administer: Procedure 10-1 • Getting ready • Preparing the medication • Administering the medication

  6. Oral Administration (cont.)  • Solid form • Liquids

  7. Nasogastric Administration • Appropriate patients • PEG tube • Medication forms: • Liquids • Pills: crushed, add water

  8. Procedure for Administering Nasogastric Medications • Aspirate stomach contents • Listen for gurgling sounds in the stomach • Listen for breath sounds • Put medication into the tubing • Instill medications via gravity • Add water to tube following medication administration

  9. Rectal Administration • Getting Ready • Preparing the medication • Administering the medication • Concluding

  10. Parenteral Medications • “Into the skin” • Routes • Reasons for parenteral administration

  11. Standard Precautions • Protect health care workers • Centers for Disease Control (CDC) • Sharps container for disposal of needles

  12. Parenteral Administration • “Into the skin” • Routes for administration • Parenteral rationale/Advantages • Disadvantages • Costs

  13. Basic Equipment • Syringes: Figure 10-2 • Types of syringes: Figure 10-3 • Volume of medication: mL or m

  14. Parts of a Syringe

  15. Needles • Needles: gauge • Hub • Specialized needles • Guide for needle selection: Table 10-1 • Needleless system: Figure 10-6

  16. Parts of the needle

  17. Needles: Gauges

  18. Chapter 10 Lesson 10.2

  19. Learning Objectives • Outline procedures for giving medications enterally, parenterally, and percutaneously • Identify anatomy landmarks used for giving parenteral medications

  20. Procedure for Preparing and Administering Parenteral Medications • Procedure for medication administration: Procedure 10-3 • Determine sight for administration • Use of equipment • Package • Medication characteristics

  21. Forms of Parenteral Medications • Vials: Figure 10-7 • Ampules: Figure 10-8 • Mix-O-Vial: Figure 10-9 • Single or Multidose vials

  22. Vial

  23. Ampules

  24. Forms of Parenteral Medications (cont.) • Combining drugs in one syringe • Mixing insulin • Prefilled syringes • IV solutions • Secondary or “piggyback”

  25. Administering Intradermal Injections • Uses • Skin anatomy and needle angle: Figure 10-12 • Bleb • Equipment and technique

  26. Intradermal Injections

  27. Administering Subcutaneous Medications • 2 mL into the loose connective tissue • Slow onset, longer duration • Placement: Figure 10-14 • Sites: Figure 10-15 • Technique

  28. Subcutaneous Injections

  29. Administering Intramuscular Medications • Location • Absorption • Equipment • Sites: Box 10-3 • Technique

  30. Intramuscular Injections

  31. Administering Intravenous Medications • Onset and absorption • Dosing and scheduling considerations • Equipment • Sites: Figures 10-18 (adult) and 10-19 (children) • Venipuncture and intravenous infusion • Procedure 10-4

  32. Intravenous sites in adults

  33. Intravenous sites in children

  34. Modifications in Technique for Specific Situations • Adding medication by syringe to an infusion • Adding medication to a plastic bag or an IV bottle • Adding medication to a volume control • Adding medication by piggyback infusion • Administration of medication when there is only an intermittent infusion device

  35. Intravenous Infusion Rates • Monitoring infusion rates • Calculating infusion rates • Infusion pumps; syringe infusion pumps • Infusion controllers and volumetric pumps • Implantable pumps • Venous access device • Common problems with intravenous infusions

  36. Percutaneous Medications • Absorption: mucous membranes or the skin • Absorption and application • Inhalation

  37. Percutaneous Administration • Factors affecting transdermal application • Skin Condition • Methods of Administration

  38. Procedures for Administering Percutaneous Medications • Applied to the area requiring treatment • Common Forms: Box 10-4

  39. Administering Topical Medications • Clean skin before application • Gloves • Lotions • Ointments • Excess medication • Dressings • Patient Education – Home Care

  40. Administering Medications to Mucous Membranes • Absorption • Sublingual • Buccal • Vaginal • Ear drops: child and adult • Eye • Nose • Respiratory

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